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Inner Circle Application Form
Email
*
Phone number
First name
Last name
What best describes your current goal?
Please Select
Lose weight/fat loss
Look more defined and toned/body composition
Build strength/muscle
Current Weight in Pounds
Goal Weight in Pounds
How long have you been on your fitness/health journey?
Please Select
Just getting started
3-6 months
6 months-1 year
1-5 years
5+ years
When it comes to nutrition, what do you struggle most with?
Please Select
Don't know what to eat
All or nothing mentality
Need accountability
Stress/Emotional eating
Other
On a scale of 1-10, what is your level of willingness to open up to your coach about things you struggle with? (1 being not willing to open up at all, 10 being I'm an open book)
Our ultimate goal is to get you to YOUR goals in a way that is sustainable, non-overwhelming, and empowering so you can keep the results for the rest of your life. With that being said, this program is an investment between $699 - $1995. Do you have the financial capability and willingness to invest that in reaching your goals?
Please Select
Yes
No
Have you worked with any coaches or personal trainers 1-on-1 before?
Please Select
Yes
No
Is there a coach that you have already an interest in working with? If so, who?
What does it mean to you to achieve these goals and how does your life look different once you reach them? (Check all that apply)
Get more done
Sleep better
Have a better attitude towards life
Set a good example for my kids
Engage or participate in activities that I currently avoid
Be more confident
Love myself more
Feel better around my significant other in intimate situations
Feel like myself again
Get off medication
Feel more physically fit for daily activities like walking up stairs.
Not have obsessive thoughts about food constantly (example: emotional eating)
Feel in control of myself and my food choices
Not fall into some of the same health traps of my loved ones
If you were to be a good fit for the Inner Circle Program and choose to enroll, what would be the NUMBER 1 thing that you would like to get out of it?
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